,NSG3600/NSG 3600 Exam 2 | Pediatric Nursing
| Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which finding is most
suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: B) Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to enter
systemic circulation and leading to hypoxemia (SpO₂ typically <90%). Bounding pulses suggest a patent
ductus arteriosus (acyanotic). Hepatomegaly suggests heart failure. Murmurs can occur in both cyanotic
and acyanotic defects.
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which pathophysiologic change
does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: A) Increased pulmonary blood flow
Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the left ventricle
forces blood through the hole into the right ventricle and pulmonary artery, increasing pulmonary blood
flow. This can lead to pulmonary congestion and heart failure if untreated.
,3. A 4-month-old infant with a large ventricular septal defect is showing signs of heart failure. Which
finding would the nurse expect?
A) Increased appetite and weight gain
B) Tachypnea and poor feeding
C) Hypertension and bounding pulses
D) Decreased respiratory rate
Correct Answer: B) Tachypnea and poor feeding
Rationale: Infants with heart failure often present with tachypnea, poor feeding, and failure to thrive
due to increased work of breathing and decreased cardiac output. Tachycardia and diaphoresis during
feeding are also common. Appetite is typically decreased, not increased.
4. Which statement is accurate regarding the ductus arteriosus in fetal circulation?
A) It connects the pulmonary artery to the aorta
B) It connects the right atrium to the left atrium
C) It allows blood to bypass the liver
D) It closes permanently within the first year of life
Correct Answer: A) It connects the pulmonary artery to the aorta
Rationale: The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass
the lungs in fetal circulation. It normally closes within the first few days after birth. An atrial septal
defect connects the atria, and the ductus venosus bypasses the liver.
5. What happens if the patent ductus arteriosus (PDA) remains open after birth?
A) Decreased pulmonary blood flow
B) Increased blood flow to the lungs
C) Cyanosis unresponsive to oxygen
D) Obstruction of the left ventricular outflow tract
, Correct Answer: B) Increased blood flow to the lungs
Rationale: If the PDA remains open, blood shunts from the aorta (higher pressure) to the pulmonary
artery (lower pressure), increasing pulmonary blood flow and causing pulmonary congestion. This can
lead to heart failure and respiratory distress if not treated.
6. A child with Tetralogy of Fallot (TOF) experiences a hypercyanotic ("tet") spell. Which nursing action is
the priority?
A) Place the child in a knee-chest position
B) Administer a bronchodilator
C) Prepare for immediate surgery
D) Place the child supine with legs elevated
Correct Answer: A) Place the child in a knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, decreasing right-to-left
shunting and improving pulmonary blood flow. This is the immediate first-line intervention for a tet
spell. Oxygen and morphine may also be given. Surgery is not performed during an acute spell.
7. The nurse is educating parents about their child's upcoming echocardiogram. Which statement by the
parents indicates a need for further teaching?
A) "My baby cannot have a bottle for 4 hours before the test."
B) "The test is non-invasive and painless."
C) "We can stay with our baby during the test."
D) "The test uses sound waves to take pictures of the heart."
Correct Answer: A) "My baby cannot have a bottle for 4 hours before the test."
Rationale: An echocardiogram is a non-invasive ultrasound; fasting is not required for this test. The test
is painless, uses sound waves, and parents are usually allowed to stay with their child. Fasting is required
for procedures requiring sedation, not for a standard echo.
| Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which finding is most
suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: B) Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to enter
systemic circulation and leading to hypoxemia (SpO₂ typically <90%). Bounding pulses suggest a patent
ductus arteriosus (acyanotic). Hepatomegaly suggests heart failure. Murmurs can occur in both cyanotic
and acyanotic defects.
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which pathophysiologic change
does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: A) Increased pulmonary blood flow
Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the left ventricle
forces blood through the hole into the right ventricle and pulmonary artery, increasing pulmonary blood
flow. This can lead to pulmonary congestion and heart failure if untreated.
,3. A 4-month-old infant with a large ventricular septal defect is showing signs of heart failure. Which
finding would the nurse expect?
A) Increased appetite and weight gain
B) Tachypnea and poor feeding
C) Hypertension and bounding pulses
D) Decreased respiratory rate
Correct Answer: B) Tachypnea and poor feeding
Rationale: Infants with heart failure often present with tachypnea, poor feeding, and failure to thrive
due to increased work of breathing and decreased cardiac output. Tachycardia and diaphoresis during
feeding are also common. Appetite is typically decreased, not increased.
4. Which statement is accurate regarding the ductus arteriosus in fetal circulation?
A) It connects the pulmonary artery to the aorta
B) It connects the right atrium to the left atrium
C) It allows blood to bypass the liver
D) It closes permanently within the first year of life
Correct Answer: A) It connects the pulmonary artery to the aorta
Rationale: The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass
the lungs in fetal circulation. It normally closes within the first few days after birth. An atrial septal
defect connects the atria, and the ductus venosus bypasses the liver.
5. What happens if the patent ductus arteriosus (PDA) remains open after birth?
A) Decreased pulmonary blood flow
B) Increased blood flow to the lungs
C) Cyanosis unresponsive to oxygen
D) Obstruction of the left ventricular outflow tract
, Correct Answer: B) Increased blood flow to the lungs
Rationale: If the PDA remains open, blood shunts from the aorta (higher pressure) to the pulmonary
artery (lower pressure), increasing pulmonary blood flow and causing pulmonary congestion. This can
lead to heart failure and respiratory distress if not treated.
6. A child with Tetralogy of Fallot (TOF) experiences a hypercyanotic ("tet") spell. Which nursing action is
the priority?
A) Place the child in a knee-chest position
B) Administer a bronchodilator
C) Prepare for immediate surgery
D) Place the child supine with legs elevated
Correct Answer: A) Place the child in a knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, decreasing right-to-left
shunting and improving pulmonary blood flow. This is the immediate first-line intervention for a tet
spell. Oxygen and morphine may also be given. Surgery is not performed during an acute spell.
7. The nurse is educating parents about their child's upcoming echocardiogram. Which statement by the
parents indicates a need for further teaching?
A) "My baby cannot have a bottle for 4 hours before the test."
B) "The test is non-invasive and painless."
C) "We can stay with our baby during the test."
D) "The test uses sound waves to take pictures of the heart."
Correct Answer: A) "My baby cannot have a bottle for 4 hours before the test."
Rationale: An echocardiogram is a non-invasive ultrasound; fasting is not required for this test. The test
is painless, uses sound waves, and parents are usually allowed to stay with their child. Fasting is required
for procedures requiring sedation, not for a standard echo.
